Pelvic Floor, Hormone Therapy, & Birth Control – Expert Insights for Moms
As part of our annual sponsorship with Reedsburg Area Medical Center, I recently had the opportunity to chat with Dr. Hobson, MD | Obstetrics and Gynecology at RAMC, to discuss important topics in women’s health.
I turned to the moms in our private group, Sauk County Mom Community, to ask what questions they had about women’s health—and those questions guided our conversation.
Here’s a Q&A breakdown of what I learned, filled with expert insights and practical advice that every mom should know. A big thank you to everyone who submitted questions and to Dr. Hobson for sharing her expertise!
Please note: This information is not meant to replace medical advice. Always consult your trusted provider for personalized guidance.
Pelvic Floor
To start, moms wanted to learn more about pelvic floor health. It’s one of those topics that often feels like no one talks about, so when you find yourself dealing with it, it can feel confusing and isolating—you’re not sure what’s normal or where to even begin.
Q: How can pregnancy and childbirth affect the pelvic floor?
A: Pregnancy and childbirth, through the growing and birthing of your baby, stretch the pelvic floor muscles and can cause laxity (weakness) to the attachments of the uterus and vagina to the pelvis, and of the vaginal walls, resulting bulging of the bladder and/or bowel into the vagina, affecting ability to hold urine, to empty the bladder, or to have a spontaneous bowel movement.
Q: What can women do to help recover?
A; To help with recovery, Kegel exercises are highly recommended before, during, and after pregnancy. Doing 20 Kegels in a row, five times daily, can improve pelvic floor tone and decrease the risk of incontinence. However, if you’re unsure whether Kegels are appropriate for your situation, consult a pelvic floor specialist for personalized advice.
Q: What else can cause your pelvic floor to weaken?
A: Outside of pregnancy and childbirth, other common causes can be chronic coughing, heavy lifting, or straining due to constipation. Symptoms of weakness include urinary incontinence, inability to completely empty the bladder, and, in some cases, a noticeable bulge at the vaginal opening. A need to press on the lower vagina in order to empty the rectum is called “splinting”, and is also common with bulging of the rectum into the vagina.
Q: When should someone seek help from a pelvic floor therapist?
A: Causes in which you should consider seeing a pelvic floor therapist include (but not limited to):
- Experience incontinence or feel that you’re not completely emptying the bladder
- Experience painful or less pleasurable sex.
- An uncomfortable pulling or pressure sensation in the pelvis or vagina
- Excessive tension in the muscles around the vagina causing painful intercourse (vaginismus)
If you think you might benefit from pelvic floor therapy, speak with your provider to determine if it’s the right next step and they may be able to write you a referral.
Problems with urinary incontinence or incomplete emptying of the bladder, or needing to “splint” to empty the rectum can also be treated with surgery. Surgeons who specialize in pelvic floor surgery are known as Urogynecologists.
Q: Are there preventive measures women can take during pregnancy to protect their pelvic floor?
A: A healthy diet during pregnancy can reduce the risk of complications. Eating plenty of fiber, fruits, and vegetables and avoiding processed foods can help ensure a healthy pregnancy and avoid unnecessarily large babies and constipation, which can increase pelvic floor strain.
Q: What are the main signs of pelvic floor dysfunction that moms should look out for?
A: Pelvic floor dysfunction can show up in two main ways: weakness and too much tension. Weakness is common after childbirth, especially within the first six weeks.
Too much tension in the pelvic floor, which is much rarer than weakness, can also cause problems, like pain during sex, when attempting to use tampons, or while riding a bike. The cause of too much tension around the vaginal opening can be physical and/or emotional trauma involving the vagina, but in many cases the cause is unknown. Muscle relaxing and pain medication used vaginally can often improve and sometimes cure excessive, painful vaginal muscle tension.
Q: How can pelvic floor dysfunction contribute to other issues?
A: Pelvic floor dysfunction can play a significant role in problems like incontinence or back pain, sometimes emerging years after childbirth. Symptoms can develop later as the body changes over time.
Hormone Replacement Therapy
Q: What is Hormone Replacement Therapy (HRT)?
Hormone Replacement Therapy (HRT) is a treatment that supplements declining hormone levels, primarily estrogen and progesterone, to help manage symptoms associated with menopause or hormonal imbalances. It can alleviate issues like hot flashes, night sweats, mood swings, vaginal dryness and painful intercoure, improving overall quality of life for many women.
HRT is available in various forms, including pills, patches, creams, and implants, and its suitability depends on individual health needs and risks.
This information is meant to provide an overview—speak with your doctor to learn if HRT might be a good fit for you.
Q: Who is a good candidate for Hormone Replacement Therapy (HRT), and when should women consider it?
A: HRT is often beneficial for women experiencing symptoms of decreasing estrogen in their 40s. Symptoms include hot flashes, night sweats, fuzzy thinking, depression, and vaginal dryness. While not for everyone, HRT can significantly improve these symptoms when paired with a healthy diet and exercise.
Q: What are the most common symptoms HRT can help alleviate?
A: HRT is effective for:
- Hot flashes
- Night sweats
- Insomnia
- Vaginal dryness
- Painful intercourse due to thin, dry vaginal mucosa
Q: Are there different types of HRT, and how do they vary?
A: Yes, the main types of HRT include:
- Estrogen available as a patch, pill, or cream.
- Progesterone which helps balance estrogen and may reduce the risk of uterine cancer, usually taken as a capsule
- Testosterone may also be used to boost libido in some women, usually used as a cream. Testosterone has not been approved for use in women by the FDA, so must be ordered from a compounding pharmacy. Insurances typically don’t cover compounded medications.
Q: What should women with a history of cancer or cardiovascular issues know about HRT?
A: Estrogen carries risks, like an increased chance of blood clots, and its link to breast cancer is still debated.
Women with a history of certain cancers or cardiovascular conditions may not be good candidates for HRT and should speak with their doctor about the risks.
Birth Control
Q: What birth control methods are best for postpartum or breastfeeding moms?
A: For the first six months postpartum, breastfeeding moms should avoid birth control containing estrogen, as it can decrease milk supply. Suitable options include:
- The mini pill
- The implant
- The shot
- The IUD (hormonal or non-hormonal)
Speak with your doctor to find the best option for you!
Q: How can moms decide between hormonal and non-hormonal birth control?
A: It often comes down to trial and error. Some women tolerate hormones well, while others experience side effects like mood swings or weight gain. Non-hormonal options, like the copper IUD, can be great for those sensitive to hormones.
Talk to your doctor about your health history and preferences to determine what works best for you.
Q: Are there birth control options for managing PCOS or endometriosis?
A: Yes! Hormonal birth control can:
- Help regulate periods and may reduce uterine cancer risk in women with PCOS.
- Reduce pain and stabilize hormone swings in women with endometriosis. Extended-cycle hormonal birth control is often recommended for endometriosis. This means instead of taking a placebo or discontinuing the hormone monthly to have a period, the birth control is taken continuously for 3 months, with 5-7 days off the pill, patch, or ring every 3 months to allow shedding of the endometrial lining.
Women’s health encompasses so many unique and important challenges, from pelvic floor recovery to considering HRT or finding the right birth control. Open conversations with trusted medical professionals—like Dr. Hobson—can make all the difference in ensuring you feel supported and informed.
This article is not intended to replace professional medical advice. Please do your own research and speak with your trusted provider for further clarification or personalized guidance.
Again, thank you again to Dr. Hobson and RAMC for their insights!
Want to dive deeper into other topics that matter to moms? Check out some of my other posts that cover topics like where to donate breastmilk in Sauk County, stress management tips for moms in everyday situations, benefits to using a menstrual cup, and more!
